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Administration and Financing

of School Health Programs

Two questions on the first questionnaire dealt with the agencies administering and financing the school health program. For each question there were four choices, namely, "Board of Education," "Board of Health or Health Department," "Jointly," and "Other (specify)."

Table 3 summarizes the information received. Table 22 includes data by regions and groups. In table 3, following the percentage figures under Groups I, II, and III, are several numbers in parenthesis which indicate the corresponding percentages for 1940.

Table 3.-Agencies responsible for financing and administering school health services in cities over 2,500 by city population group: 1950

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NOTE.-Figures in parentheses are percentages for 1940 from: U. S. Office of Education. Health Services in City Schools. By James F. Rogers. Washington, U. S. Government Printing Office, 1942.

The survey of 1940 did not include cities under 10,000. If we exclude these from the 1950 study, the figures are more readily comparable. In an attempt to compare the administration and financing of the program in 1940 and 1950, the data was recalculated, omitting Group IV. This comparison is shown in table 4.

Administration of the school health program is ordinarily done by the group which finances it. This was also the situation in 1940.

Data presented indicate that there is a definite trend towards joint administration and financing of the school health programs. However, the school health program is still predominantly administered and financed by Boards of Education.

Table 4.-Agencies responsible for financing and administering school health services in cities over 10,000: 1940 and 1950

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1 U. S. Office of Education. Health Services in City Schools. By James F. Rogers. Washington, U. S. Government Printing Office, 1942.

By regions, Boards of Education administration and financing is highest for Middle Atlantic and West North Central and lowest for South Atlantic and East South Central.

Correspondingly, these responsibilities for the Board of Health are reported as highest for South Atlantic and East South Central and lowest for Middle Atlantic, West North Central, and West South Central.

Joint authority is highest for South Atlantic and East South Central and lowest for West North Central and Middle Atlantic.

On the basis of city size, where there are enough cities in the various regions to be significant, the general trend was largely the same the country over with a higher percentage reported administered and financed by the Board of Education in the larger cities, and a relatively smaller percentage in the smaller cities. The exceptions are Middle Atlantic where there is no clear-cut trend, and New England where the Health Department and joint administration and financing are relatively more important in the cities of Group I than in any other region of the country.

This information is in keeping with that obtained in the Academy of Pediatrics' Study 11 of 1947. This study reported only organizations and not communities sponsoring the program. It showed that there was a tendency for the more densely populated areas to be administered by educational departments and the semi-rural areas to be sponsored by health departments. The study also showed the relative lack of health service in rural areas.

The percentage of programs (11.3) financed by "other" authorities, such as County Courts, and Parent-Teacher Associations, exceeded the percentage (5.9) administered by such agencies. This difference in percentage is explained by the fact that, of the programs financed by non-official agencies, many are administered by Boards of Education and a few by Boards of Health.

11 John P. Hubbard, Katherine Bain, and Maryland Y. Pennell. School Health Services. Journal of School Health, 19: 143-48, June 1949.

Administration

For all the 2,886 cities reporting school health services, 60.2 percent were administered by the Board of Education; 10.9 percent by the Board of Health; 23.0 jointly by Boards of Education and Health; and 5.9 percent by other authorities.

In 1940, for all cities of 10,000 and above, 73.4 percent were administered by the Board of Education; 14.3 percent by the Board of Health; and 12.6 percent by joint authority. There were no other administering agencies. In 1950, the Board of Education administration for cities of 10,000 and above had dropped from 73.4 percent to 65.6 percent; the Board of Health administration from 14.3 percent to 10.0 percent; the joint authority administration had increased from 12.6 percent to 21.3 percent; and "other" authorities had increased from 0.0 to 3.1 percent. Certain other comparisons between 1940 and 1950 for Groups I, II, and III are shown in tables 5, 6, and 7.

Table 5.-Trends in the administration of school health services in cities of 100,000 or more population (Group I) 1922-1950

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1 Health Services in City Schools. Report of Joint Committee on Health Problems in Education of the National Education Association and the American Medical Association, New York, 1922. p. 4.

U. S. Office of Education. School Health Activities in 1930. By James F. Rogers. Washington, U. S. Government Printing Office, 1931.

U. S. Office of Education. Health Services in City Schools. By James F. Rogers. Washington, U. S. Government Printing Office, 1942.

Group I.-Of the 93 cities reporting in Group I, 57, or 61.3 percent, indicated that the Board of Educations was the administering agency; 12, or 12.9 percent, the Board of Health; 21, or 22.6 percent, joint administration; and 3, or 3.2 percent, other methods.

The percentage range by regions for Board of Education administration is 100.0 to 30.0 with West North Central and West South Central highest and South Atlantic and New England lowest.

Group II.-Cities in the second group have the following percentages for administrative authority: Board of Education, 66.1; Board of Health, 13.9; joint administration, 18.7; and other methods, 1.3.

By regions, the percentages of cities in this group having administration by the Board of Education range from 93.9 to 20.0 percent. It is

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Table 6.—Trends in the administration of school health services in cities from 30,000 to 100,000 population (Group II) 1922-1950

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1 Health Services in City Schools. Report of Joint Committee on Health Problems in Education of the National Education Association and the American Medical Association, New York, 1922. p. 4. column includes cities of 25,000 to 100,000 population.)

(This

U. S. Office of Education. School Health Activities in 1930. By James F. Rogers. Washington, U. S. Government Printing Office, 1931.

U. S. Office of Education. Health Services in City Schools. By James F. Rogers. Washington U. S. Government Printing Office, 1942.

highest in Middle Atlantic and Pacific and lowest in East South Central and South Atlantic.

Highest in the percentage of cities reporting the Board of Health as the administrative agency is New England with 33.3 percent and South Atlantic with 26.5 percent. Three regions-West North Central, West South Central, and Mountain—report no cities in Group II under Board of Health administration.

Joint administration ranges from 60.0 to 2.0 percent. It is the highest in East South Central and South Atlantic and lowest in Middle Atlantic and Pacific.

Group III.-Cities in the third city group indicated the following agencies as the administrative authorities: Board of Education, 66.0 percent; Board of Health, 8.1 percent; joint administrations, 22.2 percent; and other, 3.7 percent.

The percentages of cities in this group having the administration done by Boards of Education range, by regions, from 89.4 to 11.1 percent. The highest percentage is in Middle Atlantic and West North Central and lowest in South Atlantic and East South Central.

Administration under Boards of Health varies from 31.7 to 0.0 percent with South Atlantic and East South Central being highest and Mountain and Middle Atlantic lowest.

Joint administration ranges from 50.8 to 5.9 percent with South Atlantic and East South Central having the highest percentages and Middle Atlantic and West North Central the lowest.

Table 7.-Trends in the administration of school health services in cities from 10,000 to 30,000 population (Group III) 1922-1950

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1 Health Services in City Schools. Report of Joint Committee on Health Problems in Education of the National Education Association and the American Medical Association, New York, 1922. p. 4. column includes cities of 10,000 to 25,000 population.)

(This

U. S. Office of Education. School Health Activities in 1930. By James F. Rogers. Washington, U. S. Government Printing Office, 1931. U. S. Office of Education. Health Services in City Schools. By James F. Rogers. Washington, U. S. Government Printing Office, 1942.

Group IV. Of the four city population groups, Board of Education administration is lowest in Group IV, with 57.3 percent reporting this agency. The Board of Health administers in 11.4 percent of the cities. Joint administration is highest in this city size with 24.0 percent reported. The percentage range by regions for Board of Education administration is 84.0 to 15.0 with West North Central and Middle Atlantic highest and South Atlantic and East South Central lowest.

Board of Health administration varies from 38.8 to 1.2 percent. The highest percentages occur in East South Central and South Atlantic and the lowest in New England and Middle Atlantic.

Joint administration ranges from 53.3 percent to 6.3 percent. Highest are South Atlantic and East South Central and lowest are West North Central and Middle Atlantic.

Regions. For the United States as a whole, the percentages of cities, by regions, administered by Boards of Education range from 83.3 to 17.1 percent. It is highest in West North Central and Middle Atlantic and lowest in South Atlantic and East South Central.

The percentages for Boards of Health administration vary from 33.8 to 2.0 percent. The highest is in East South Central and South Atlantic and the lowest in Middle Atlantic and Mountain.

Joint administration ranges from 50.2 percent to 7.8 percent with the highest in South Atlantic and East South Central and the lowest in West North Central and Middle Atlantic.

On the basis of city size by region, those reporting for joint administration are, in percent, as follows:

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